SPECT scan and cognitive findings in subclinical hepatic encephalopathy

The authors studied 6 patients with end-stage cirrhosis and 6 age- and sex-matched normal control subjects by using SPECT brain scans to determine whether subclinical hepatic encephalopathy (HE) altered regional cerebral blood flow (rCBF). In addition, cirrhosis patients performed a battery of standardized neuropsychological tests known to be sensitive to effects of liver disease, and these were compared with published norms. Results of cognitive tests that showed impairment were correlated with ratios of rCBF values. In cirrhosis patients, rCBF was decreased in bilateral frontotemporal and right basal ganglia regions as compared with control subjects. These defects were compatible with the cirrhosis patients' visuopractic neuropsychological deficits, which were consistent with known subclinical HE cognitive patterns.